| NPI | 1891079059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA51853) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015187) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2023-08-02 |